Venous resection in urological surgery.
OBJECTIVE
Complete removal of retroperitoneal and pelvic tumors may require resection or ligation of major retroperitoneal, pelvic and mesenteric venous structures. We provide an overview of venous anatomy and collateral drainage, and review the veins that can be safely resected.


METHODS
We reviewed major anatomical texts, and performed a directed MEDLINE literature search of retroperitoneal, pelvic and mesenteric venous anatomy. Resection and reconstruction of these vessels were also reviewed with an emphasis on collateral blood flow and post-resection sequelae.


RESULTS
The infrarenal inferior vena cava, iliac veins, left renal vein, lumbar veins, inferior mesenteric vein and splenic vein may be resected or ligated without reconstruction. Resection of the right renal vein results in renal demise in the majority of instances. The portal vein may not be resected without reconstruction. Venous reconstruction may be performed with autologous or synthetic graft material.


CONCLUSIONS
Most major veins in the body can be safely resected or ligated with minimal sequelae. However, it is imperative to understand venous anatomy and collateral blood flow to minimize intraoperative and postoperative complications.
Duty
Brian
B
Division of Urology and Renal Transplantation, Section of Urologic Oncology, Oregon Health & Science University, Portland, Oregon 97239, USA.
Daneshmand
Siamak
S
D006801:Humans; D007084:Iliac Vein / Q000033:anatomy & histology / Q000601:surgery; D012082:Renal Veins / Q000033:anatomy & histology / Q000601:surgery; D014551:Urinary Tract / Q000033:anatomy & histology* / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000033:anatomy & histology / Q000601:surgery